Human Resources

Fourth Circuit Rules that ADA Protects Gender Dysphoria

Attorney Harrison Oldham




On August 16, 2022, the Fourth Circuit Court of Appeals issued the historic decision of Williams v. Kincaid, where the Court held that gender dysphoria qualifies as a disability under the Americans with Disabilities Act of 1990 (“ADA”) and Rehabilitation Act.


The decision is the first of its kind from a Federal Court of Appeals.



Ms. Williams, a transgender woman with gender dysphoria, was incarcerated in a Virginia correctional facility.  Before her incarceration, Ms. Williams received medical treatment for gender dysphoria for 15 years, including hormone therapy in the form of a daily pill and biweekly injections.  Additionally, she was recognized as female by her home state of Maryland, and her driver’s license also declared that she was a female.


However, as part of her petition, Ms. Williams alleged that the defendants violated the ADA when they transferred her from women’s housing to men’s housing after discovering she was a transgender woman.  She further asserted that the defendants delayed her medical treatment for gender dysphoria and that she experienced harassment by inmates and prison officials.


After her release, Ms. Williams sued the correctional facility asserting violations of the ADA, the Rehabilitation Act, the U.S. Constitution, and Virginia state common law. After the defendant filed a motion to dismiss, the district court dismissed the ADA and Rehabilitation Act claims on the basis that gender dysphoria did not constitute a disability under the statutes.


On appeal, the defendants did not dispute that gender dysphoria met the ADA’s definition of a disability: “a physical or mental impairment that substantially limits one or more major life activities of such individual.” 42 U.S.C. § 12102(1)(A).  Instead, the defendants argued that the ADA explicitly excluded from its statutory protections “gender identity disorders not resulting from physical impairments,” among other conditions.  In response, Williams argued that gender dysphoria was not a gender identity disorder and, even if it were, that it results from a physical basis and is thus outside the scope of the ADA exclusion.


Following its review, the Fourth Circuit held that the term should be understood as it was “at the time of its enactment” and ruled that gender dysphoria met the definition of a “disability” under the ADA.  The Fourth Circuit ultimately reversed and remanded the matter to the trial court for further proceedings.


Is “Gender Dysphoria” Covered Under the ADA?

The ADA broadly defines “disability” as “a physical or mental impairment that substantially limits one or more major life activities of such individual.” 42 U.S.C. § 12102(1)(A).  However, the ADA excludes from this definition “gender identity disorders not resulting from physical impairments.”  So, to reach its conclusion, the Fourth Circuit looked to the medical community to facilitate its interpretation of “gender dysphoria” under the ADA.


Psychology.org defines “gender dysphoria” as “psychological distress that results from an incongruence between one’s sex assigned at birth and one’s gender identity.” Though gender dysphoria often begins in childhood, some people may not experience it until after puberty or much later.


After analyzing applicable precedent, the Fourth Circuit determined that the ADA’s definition of a “disability” includes gender dysphoria and that gender dysphoria does not fall within the “gender identity disorders,” which are excluded from the ADA’s protection.  The Court further emphasized that “a diagnosis of gender dysphoria, unlike that of ‘gender identity disorder,’ concerns itself with distress and other disabling symptoms, rather than simply being transgender.


Key Takeaways

Employers (well, at least those in the 4th circuit – Maryland, North Carolina, South Carolina, Virginia, and West Virginia) must engage in the interactive process with employees who are qualified individuals with gender dysphoria, which the Fourth Circuit now considered a disability under the ADA. This ruling also affords employees with gender dysphoria the ADA’s protections against harassment, retaliation, and discrimination.


Employers with employees in the 4th circuit should now prepare to provide reasonable accommodations to employees with gender dysphoria. Accommodations could branch from medical treatments, hormone therapy, leaves of absence, shift assignments, housing sponsored by employers, and restroom usage, meaning that employers should begin to understand where accommodations may need to be provided.


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About Harrison Oldham

Harrison grew up in Mansfield, Texas. He attended Texas A&M University for his bachelor’s degree, where he met his wonderful wife, Kelsey. After graduating magna cum laude from Texas A&M, he attended SMU Dedman School of Law, graduating with honors in 2012. Today, Harrison and his wife live in Dallas, Texas with their son, Teddy.

Since graduating from SMU Law, Harrison has worked exclusively in the field of business law. He has spent time in private practice and in-house, working with clients of every size; from single person startups to Fortune 250 companies. Today his practice focuses on serving the diverse needs of businesses and individuals throughout Texas. You can learn more about Harrison by visiting his website, at: http://lonestarbusinesslaw.com/.

The post Fourth Circuit Rules that ADA Protects Gender Dysphoria appeared first on Your HelpDesk for HR .

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